Acne

Acne

Acne is a common skin condition affecting teenagers and adults.  Acne cannot be cured permanently. Genes play a part. Acne will have to run its course. For some people, acne may clear by late teens while others may have acne till late adulthood. It is highly recommended not to ignore acne and to treat early to prevent permanent acne scars.

For mild acne with only whiteheads or blackheads (the non-inflammatory acne), acne treatment with creams is effective. However, if your acne continues to worsen or if you have inflammatory acne (red bumps or painful bumps with pus), then you need to consult a dermatologist.  Early treatment of acne is important to prevent acne scars.

Acne can present as

  • Mild acne with mainly whiteheads (closed comedones) and blackheads (open comedones)
  • Moderate acne with small red, tender bumps (papules) or bumps with pus (pustules)
  • Severe acne with large, painful lumps beneath the surface of the skin (nodules) and acne cyst

Acne Treatment

The main aim of treating acne is to clear acne and to prevent acne scars.  Dr Joyce Lim will tailor the most appropriate treatment based on your condition. Treatment options include

  • Prescription creams or gels containing retinoic acid or antibiotics
  • Oral medication such as antibiotics, hormonal pills, or isotretinoin (vitamin A)
  • Chemical peels
  • LED light treatments
  • Light and laser treatments
  • Gold Photothermal therapy

Gold Photothermal Therapy (Gold PTT) to treat acne vulgaris

Gold Photothermal Therapy (Gold PTT) uses a topical application of gold micro particles and targeted heat from a specific laser to treat acne vulgaris (US FDA approved treatment). In addition, Gold PTT can improve enlarged facial pores and reduce sebum production.

Gold Photothermal therapy (Gold PTT) Mechanism of Action

  • Gold particles have an affinity for the sebaceous glands and duct. They are delivered and concentrated within the sebaceous glands and ducts using an ultrasound delivery system
  • Gold microparticles generate heat when they are excited by a specific wavelength of laser light
  • A laser with an infra-red wavelength (usually between 800-1064nm) is used to selectively heat up the gold particles which surround the sebaceous glands and duct without damaging the surrounding normal skin
  • The generated heat targets the sebaceous glands, the ducts and the bacteria, all of which are causes of acne

Gold Photothermal therapy (Gold PTT) in the treatment of acne

Acne is due to 4 factors

  • Overactive sebaceous (oil) glands
  • Hyperkeratinisation (blockage) of the duct of the oil glands
  • Bacteria proliferation
  • Skin inflammation

Gold Photothermal Therapy (Gold PTT ) targets the factors causing acne vulgaris

  • Gold PTT targets overactive sebaceous glands
  • Gold PTT targets the hyperkeratinizing cells of the duct
  • Gold PTT heats the acne lesions and reduce the bacteria in the oil glands
  • Gold PTT induce sebum reduction

(Paithankar Dy et al J of Investigative Dermatol 2015)

Gold Photothermal Therapy - Gold PTT Acne Treatment
  • The skin is cleansed
  • The gold micro particles are applied on the skin
  • Ultrasound is used to massage and deliver the gold micro particles into the pores and the sebaceous glands
  • Any excess gold particles are removed with a wet gauze
  • The 1064nm laser light ( Laser Genesis or Splendour X) is applied to the skin
  • The gold particles concentrate the laser light within the sebaceous glands and the heat from the laser destroyed the glands, the bacteria and reduce oil production
  • You may feel a warm sensation or a sensation of tiny needle pricks. No anaesthesia is required
  • The whole treatment takes about 35 -40 minutes
  • There may be mild redness after the procedure which subsides spontaneously
  • Post treatment cream is applied after the procedure
  • Generally 3 treatments at 2 weekly intervals are done

Safety of Gold Photothermal Therapy (Gold PTT)

  • Cytotoxicity test shows that gold nanoparticles is not toxic to human cells
  • Any gold particles that is left in the skin after the procedure will be shed away naturally when the skin renews itself

Acne scars

During treatment, acne can heal with red and brown marks and superficial or deep dents in the skin. There are treatments to prevent and reduce these scars. Treatments can be started alongside treatments for acne.

Treatments for acne scars

  • Prescription creams or gels to reduce or clear redness and brown marks
  • Chemical peels
  • Injectables
  • Light and laser treatments
  • Jet Volumetric remodeling (Enerjet)
  • Tixel skin resurfacing
  • Fractional radiofrequency